Global Burden of Cardiovascular Diseases

In recent years, the dominance of chronic diseases as major contributors to total global mortality has emerged and has been previously described in detail elsewhere. By 2005, the total number of cardiovascular disease (CVD) deaths (mainly coronary heart disease, stroke, and rheumatic heart disease) had increased globally to 17.5 million from 14.4 million in 1990. Of these, 7.6 million were attributed to coronary heart disease and 5.7 million to stroke. More than 80 percent of the deaths occurred in low and middle income countries (WHO, 2009e).

Based on 2007 to 2010 data, 33% of US adults ≥ 20 years of age have hypertension. This represents ~ 78 million US adults with hypertension. The prevalence of hypertension is similar for men and women. African American adults have among the highest prevalence of hypertension (44%) in the world.

Blood pressure, weight and kidney disease risks

Oct 14, 2009 Viewed: 562

People with prehypertension are not at increased risk of kidney disease if their body mass index (BMI) is under 30.0 kg/m2, a first-ever examination of the combined effect of blood pressure and body weight on the risk of kidney disease shows.

The study, by a team of medical researchers at the Norwegian University of Science and Technology (NTNU) is available as a pre-publication article online from the American Journal of Kidney Diseases.

Prehypertension is a relatively new medical classification introduced in 2003 in the Seventh Report of the Joint National Committee on High Blood Pressure (JNC-7), and is defined as systolic blood pressure of 120 to 139 mm Hg or diastolic BP of 80 to 89 mm Hg. Studies from the United States and Asia have shown that prehypertension can increase the risk of serious kidney disease, but because more than 30 percent of the US and European populations can be classified as prehypertensive, treating everyone with this condition would be an enormous undertaking, the researchers observed.

At the same time, obesity is also known to lead to end-stage renal disease (ESRD) and death from chronic kidney disease (CKD) as a result of diabetes and hypertension. These increased risks have led medical researchers to consider whether people with prehypertension should be considered for treatment if they have other cardiovascular risks, such as obesity.

Using data from nearly 75,000 participants in the HUNT 1 study, the first Health Study in Nord-Trøndelag, a team of NTNU researchers led by Dr. John Munkhaugen were able to further clarify the risks of ESRD in overweight individuals.

“We found a strong, independent and continuous association with both BP and body weight” on the risk of treated ESRD or chronic kidney disease related deaths, the researchers wrote. However, “prehypertensive participants increased their risk of treated ESRD or CKD-related death only if BMI was greater than 30.0 kg/mg2.”

The strength of the NTNU study is its ability to use data from the two-decade old HUNT 1 study, which provides researchers the ability to follow up on measurements made 20 years ago. The HUNT 1 study involved 88.2 percent of all inhabitants 20 years or older in Nord-Trøndelag county, in mid-Norway. The data were linked to the Norwegian Renal Registry and to the Cause of Death Registry in Norway.

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